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The acceptability and feasibility of conducting a randomised controlled trial to test the effectiveness of a walking intervention for older people with persistent musculoskeletal pain in primary care: A mixed methods evaluation of the iPOPP pilot trial

Healey, Emma L.; McBeth, John; Nicholls, Elaine; Chew‐Graham, Carolyn A.; Dent, Stephen; Foster, Nadine E.; Herron, Daniel; Pincus, Tamar; Hartshorne, Liz; Hay, Elaine M.; Jinks, Clare


Emma L. Healey

John McBeth

Elaine Nicholls

Stephen Dent

Nadine E. Foster

Daniel Herron

Tamar Pincus

Liz Hartshorne


Introduction: Persistent musculoskeletal (MSK) pain is associated with physical inactivity in older people. While walking is an acceptable form of physical activity, the effectiveness of walking interventions in this population has yet to be established. Objectives: To assess the acceptability and feasibility of conducting a randomised controlled trial (RCT) to test the effectiveness of a healthcare assistant‐led walking intervention for older people with persistent MSK pain (iPOPP) in primary care. Methods: A mixed method, three arm pilot RCT was conducted in four general practices and recruited patients aged ≥65 years with persistent MSK pain. Participants were randomised in a 1:1:1 ratio to: (i) usual care, (ii) usual care plus a pedometer intervention, or (iii) usual care plus the iPOPP walking intervention. Descriptive statistics were used in an exploratory analysis of the quantitative data. Qualitative data were analysed using thematic analysis. A triangulation protocol was used to integrate the analyses from the mixed methods. Results: All pre‐specified success criteria were achieved in terms of feasibility (recruitment, follow‐up and iPOPP intervention adherence) and acceptability. Triangulation of the data identified the need, in the future, to make the iPOPP training (for intervention deliverers) more patient‐centred to better support already active patients and the use of individualised goal setting and improve accelerometry data collection processes to increase the amount of valid data. Conclusions: This pilot trial suggests that the iPOPP intervention and a future full‐scale RCT are both acceptable and feasible. The use of a triangulation protocol enabled more robust conclusions about acceptability and feasibility to be drawn.

Journal Article Type Article
Acceptance Date Aug 24, 2023
Online Publication Date Sep 9, 2023
Deposit Date Sep 21, 2023
Journal Musculoskeletal Care
Print ISSN 1478-2189
Publisher Wiley
Peer Reviewed Peer Reviewed
Keywords data triangulation, older people, musculoskeletal pain, randomised controlled trial, walking, physical activity, primary care